III Medical Department with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute (SCRI) with Laboratory of Immunological and Molecular Cancer Research (LIMCR) and Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria.
Breast Care (Basel). 2014 Oct;9(5):323-30. doi: 10.1159/000368710.
Bone-targeted therapies like bisphosphonates (zoledronic acid or pamidronate) or denosumab are recommended in all patients with metastatic breast cancer and bone metastases, whether they are symptomatic or not. The choice between these 2 different agents, however, remains open. In this review, we critically discuss the emerging evidence for direct anti-tumor activity of bone-targeting agents, the utility of bone turnover markers for treatment decision and efficacy prediction, as well as the safety and financial aspects of bisphosphonates and denosumab. Furthermore, we provide a possible therapeutic algorithm, and present new pharmacologic agents which are being investigated for the treatment of metastatic bone disease.
对于有转移乳腺癌和骨转移的所有患者，无论其是否有症状，都建议使用骨靶向治疗药物，如双膦酸盐（唑来膦酸或帕米膦酸）或地诺单抗。然而，这两种不同药物的选择仍然存在争议。在这篇综述中，我们批判性地讨论了骨靶向药物的抗肿瘤活性的新证据，骨转换标志物在治疗决策和疗效预测中的作用，以及双膦酸盐和地诺单抗的安全性和经济性。此外，我们提供了一个可能的治疗算法，并介绍了正在研究用于治疗转移性骨病的新的药物。
